Kids' Food Allergies are Skyrocketing – Is the Spike Real?

A couple years ago, I found out that I'm allergic to peaches. I've had a handful of food allergies for my entire life, but they have been mostly petty annoyances─stomachache after eating cherries, that sort of thing. And I had eaten peaches for my entire life with no apparent difficulty. However, one afternoon, I took a single bite of a peach. As the fruit traveled down my throat, my throat felt like it was collapsing. My voice disappeared to a raspy whisper. I was told later that I should have gone to the hospital, but I didn't know that at the time. Instead, I just took a Benadryl and went to bed.

Since then, I've had allergy testing, and I discovered that I have 33 other food allergies to go along with my peach allergy. I'm allergic to the usual suspects (shellfish, tree nuts), but I'm also allergic to corn, oats, spinach, garlic, and basil. In some odd version of a Taoist riddle, I'm allergic to chicken, but not the egg. And if you aren't yet feeling my pain─I'm also allergic to chocolate and coffee.

Some people don't even believe I have 34 allergies. Sometimes, even I think it can't be true. Then, I have a few bites of chicken. Suddenly, my tongue and throat go numb, and I have trouble talking.

Which is why I was fascinated by a study released today─on kids and food allergies.

In Pediatrics, Amy Branum and Susan L. Lukacs, researchers at the Centers for Disease Control and Prevention, report that the number of kids with food allergies has jumped up 18 percent in the past 10 years. The overall prevalence is still quite low (3.9 percent of kids have allergies), but that kind of a leap gives researchers pause.

"We do think this is an increasing trend," confirms Branum. And "anytime you see any health condition going up─that's always a concern. Going up is not the right direction."

Branum and Lukacs also found that the number of kids seeking emergency medical treatment for an adverse reaction to food has tripled in the past few years. In 2006, 317,000 kids were rushed to doctors' offices and hospitals because of something they ate.

What is particularly scary about food allergies, says Branum, is that they are "extremely unpredictable." A minor reaction can become a life-threatening condition with no warning. Essentially a response from the immune system, allergic reactions are not proportional to the amount of food ingested: a very small amount can trigger anaphylaxis, a whole-body reaction. An allergic person may be one peanut away from wheezing or coughing, his airways tightening until he turns blue. He may become confused or anxious; he may slur his speech. He may develop an irregular heart rhythm and other symptoms. True anaphylaxis is rare, but, when it occurs, it can be fatal.

Worries over the increasing number of children's food allergies are not confined to the U.S: it's a subject of concern throughout Europe as well.

Trying to figure out why allergies are on the rise, teams in 19 European countries, Ghana, India, and China have now begun work on a project known as EuroPrevall. The researchers plan on tracking 9,000 children for years, looking for 24 common food allergies.

One of the EuroPrevall challenges is that allergens differ by what part of the world you live in. For example, in the U.S. and Japan, the most common food allergens include milk, eggs, wheat, soy, and peanuts. In the Mediterranean, peaches are a frequent concern, but that isn't so in Northern Europe. In Russia, Estonia, and Lithuania, citrus, and fish are among the most common allergens, while in Sweden and Denmark, tree nuts and pears are more of a problem.

And there can be new triggers as well. Across Europe, kiwi is "an emerging food allergen." CDC's Branum has been hearing that in the U.S., sesame allergies are on the rise.

Contrary to popular thought, food allergies are not a new phenomenon, and they aren't simply a product of a modern diet. In the first century, Hippocrates described the symptoms of an allergy to milk, while reports of fish and egg allergies go back as far as the 16th and 17th centuries.

So one of the first tasks for EuroPrevall will be to confirm that there is an actual increase in allergy prevalence. The other explanation is that heightened awareness─due to media reports of kids who die from a peanut butter sandwich─has made parents and physicians more vigilant about allergies they would have otherwise ignored. This parent-fear factor is considered as a serious explanation, particularly since about 25 percent of American adults claim to have an allergy, but the real adult prevalence is probably not much different from that of kids─about 2 to 4 percent.

One reason for this overreporting is that there is a lot of confusion about just what an allergy is. Allergies are often confused with food intolerances─when food is difficult to digest. But a food intolerance is considered less serious than an allergy, because (unlike allergies) a person with a food intolerance generally has a predictable reaction to the food, and the symptoms are proportionate─the more food ingested, the stronger the reaction.

Initially, Branum was among those who suspected that parent fear was the real explanation behind the reported allergy increases. However, she isn't as sure now. If fear was the only explanation, then she might have seen differences across racial and ethnic lines. But Branum found allergy increases in each demographic group─that indicates that there's a biological, not cultural, factor at work.

Also, Branum compared parent reports of kids' allergies to a nationally representative clinical assessment of kids' health─which included testing kids' blood samples for antibodies to allergens. In the CDC sample, 9 percent of the kids had IgE antibodies for peanuts; 12 percent had them for milk. Five percent had the shrimp IgE, while almost 7 percent had them for eggs. Many of those were the same kids who had reactions to several foods. Also, children can grow out of allergies, but still get a positive antibody test. If an infant had a milk allergy that was gone by the time she was 2, the antibodies would still be present in her system for years.

Branum's analysis of this data ultimately confirmed that parents were being pretty accurate about their kids' allergies. Parents weren't just being hysterical; their kids probably really did have the allergies parents were listing.

Amazingly, just two years ago, children's food allergies weren't even on the CDC's radar. The agency had some scattered data in studies, but it had never occurred to anyone that the CDC should take a more thorough look at the research. It wasn't until the staff of Sen. Christopher Dodd called, asking for a briefing on the issue (Dodd's daughter has a severe tree-nut allergy), that the CDC began a more comprehensive analysis.

Branum volunteered for the task. But once she'd finished briefing Dodd's staff, she decided that the information could be useful to other scholars, and she set about publishing the research. The Pediatrics study is actually an outgrowth of her first briefing for the congressional staff.

Now, Branum has quickly become the CDC food-allergy expert. And the CDC has realized that it needs to be doing more for kids with food allergies.

With the U.S. Department of Agriculture, the CDC is now regularly bringing parents, educators, school administrators, and policy experts together to figure out how to best care for kids with allergies. They are tackling how kids can bring medicines to schools with zero-tolerance policies. They are figuring out what sort of staff training should be required for emergencies.

They're also listening to the kids. Says Branum, "They don't want to be treated differently. Don't force them to sit at a lunch table by themselves. They are very educated about their allergies─they know what to ask and what to do."

But then the kids have to know that. Their lives may depend on it.